Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins
B4153 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.
Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?
Cost Key: |
Lower Cost | Medium Cost | Higher Cost |
Facility  |
City/State |
Average Cost Range  |
||
|---|---|---|---|---|
 |
Allina Community Pharmacies (15) | $1.96 - $2.47 | |||||
| Abbott NW Medical Bldg Pharmacy | Minneapolis, MN | $1.96 - $2.47 | |||||
| Abbott NW Piper Bldg Pharmacy | Minneapolis, MN | $1.96 - $2.47 | |||||
| Cottage Grove Pharmacy | Cottage Grove, MN | $1.96 - $2.47 | |||||
| Healthcare Pharmacy | Coon Rapids, MN | $1.96 - $2.47 | |||||
| Heart Hospital | Minneapolis, MN | $1.96 - $2.47 | |||||
| Medical Arts Building | Minneapolis, MN | $1.96 - $2.47 | |||||
| Mercy Hospital Outpatient Pharmacy | Coon Rapids, MN | $1.96 - $2.47 | |||||
| Owatonna Pharmacy Care | Owatonna, MN | $1.96 - $2.47 | |||||
| PEI Pharmacy | Minneapolis, MN | $1.96 - $2.47 | |||||
| Ritchie Medical Plaza Pharmacy | Saint Paul, MN | $1.96 - $2.47 | |||||
| Rum River Drug | Cambridge, MN | $1.96 - $2.47 | |||||
| United Hospital Outpatient Pharmacy | Saint Paul, MN | $1.96 - $2.47 | |||||
| Unity Community Pharmacy | Fridley, MN | $1.96 - $2.47 | |||||
| Westhealth Pharmacy | Plymouth, MN | $1.96 - $2.47 | |||||
| Woodbury Pharmacy | Woodbury, MN | $1.96 - $2.47 | |||||
|
Allina Home Oxygen & Medical Equipment (10) | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Hutchinson, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Owatonna, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Saint Paul, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | New Ulm, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Buffalo, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Fridley, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Coon Rapids, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Minneapolis, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Saint Paul, MN | $1.96 - $2.47 | |||||
| Allina Home Oxygen & Medical Equipment | Cambridge, MN | $1.96 - $2.47 | |||||
|
Apria Healthcare Inc - Home Oxygen & Medical Equipment (22) | $1.96 - $2.47 | |||||
| Apria Healthcare Inc | Rochester, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc | Spearfish, SD | $1.96 - $2.47 | |||||
| Apria Healthcare Inc | Wisconsin Rapids, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc | Rothschild, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Saint Cloud, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | New Berlin, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Saint Paul, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Sioux Falls, SD | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Marshfield, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Green Bay, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Duluth, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Neenah, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Onalaska, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Minocqua, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rice Lake, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Eau Claire, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Monona, WI | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Minnetonka, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rochester, MN | $1.96 - $2.47 | |||||
| Apria Healthcare Inc - Home Oxygen & Medical Equipment | Rapid City, SD | $1.96 - $2.47 | |||||
| Apria Pharmacy Network | Oxnard, CA | $1.96 - $2.47 | |||||
| Apria Pharmacy Network | Folcroft, PA | $1.96 - $2.47 | |||||
| Aspen Medical Group - Musculoskeletal Center | Saint Paul, MN | $1.96 - $2.47 | |||||
|
Fairview Pharmacy Services (38) | $1.96 - $2.47 | |||||
| Fairview Blaine Pharmacy | Blaine, MN | $1.96 - $2.47 | |||||
| Fairview Home Infusion | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Saint Paul, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Eden Prairie, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Edina, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Andover, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Eagan, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Rush City, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Burnsville, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Columbia Heights, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Milaca, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Lino Lakes, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Bloomington, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Elk River, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Maple Grove, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Apple Valley, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Edina, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Wyoming, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Red Wing, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Hugo, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Zimmerman, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Brookyln Park, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Princeton, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Edina, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview Pharmacy Services | New Brighton, MN | $1.96 - $2.47 | |||||
| Fairview University Clinic Pharmacy | Minneapolis, MN | $1.96 - $2.47 | |||||
| Fairview University Discharge Pharmacy | Minneapolis, MN | $1.96 - $2.47 | |||||
| Key Medical Supply Inc | Shoreview, MN | $1.96 - $2.47 | |||||
|
MeritCare HealthCare Accessories LLC (14) | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Bemidji, MN | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Minot, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Bemidji, MN | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Fargo, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Thief River Falls, MN | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Bismarck, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Thief River Falls, MN | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | East Grand Forks, MN | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Minot, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Fargo, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Bismarck, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Jamestown, ND | $1.96 - $2.47 | |||||
| MeritCare Healthcare Accessories LLC | Jamestown, ND | $1.96 - $2.47 | |||||
| Sanford Healthcare Accessories | East Grand Forks, MN | $1.96 - $2.47 | |||||
| Midwest Medical Services | Mounds View, MN | $1.96 - $2.47 | |||||
| Pediatric Home Services - Home Medical Equipment | Roseville, MN | $3.60 - $4.40 | |||||
|
Reliable Medical Supply Inc (3) | $1.96 - $2.47 | |||||
| Reliable Medical Supply, Inc | Brooklyn Park, MN | $1.96 - $2.47 | |||||
| Reliable Medical Supply, Inc | Waite Park, MN | $1.96 - $2.47 | |||||
| Reliable Medical Supply, Inc | Buffalo, MN | $1.96 - $2.47 | |||||
| Sanford Healthcare Accessories LLC | Fargo, ND | $1.96 - $2.47 | |||||
| Sanford Healthcare Accessories LLC | Fargo, ND | $1.96 - $2.47 | |||||
|
Sports and Orthopaedic Specialists (4) | $1.96 - $2.47 | |||||
| Sports and Orthopaedic Specialists P.A. | Saint Cloud, MN | $1.96 - $2.47 | |||||
| Sports and Orthopaedic Specialists P.A. | Blaine, MN | $1.96 - $2.47 | |||||
| Sports and Orthopaedic Specialists P.A. | Edina, MN | $1.96 - $2.47 | |||||
| Sports and Orthopaedic Specialists P.A. | Minneapolis, MN | $1.96 - $2.47 |
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